MASC (Masking Scale)

What MASC measures

MASC measures camouflaging: the work of watching yourself, adjusting yourself and rehearsing yourself so you come across the way other people expect. Fifty-four questions in total. Forty-eight of them make up the core scale, spread across five areas. The last six sit in two newer modules that are reported separately.

It reports averages rather than a total. You get an average answer out of 4 for each area, an average across the forty-eight core questions and a verdict on whether that core average sits above or below the threshold from our validation study.

The five core areas are masking strategies, social anxiety, exhaustion and burnout, the effect on your sense of self, then avoiding and concealing. The two newer modules cover hiding attention and memory difficulty, and collapse after forced focus.

MASC is validated on an initial cohort of 115 women and non-binary adults. That is a real study with a real threshold, and it is also a small sample from one group, so the label on this page says initial cohort rather than anything grander. The two newer modules are pending separate validation, which is why they are shown apart from the core average and do not count towards it.

Who it is designed for

MASC was written for women, non-binary people and trans people whose neurodivergence is hidden behind something that works. It was validated with women and non-binary adults.

If you have been told you cannot be autistic because you make eye contact, hold a conversation or have friends, this is the instrument that asks about the effort behind those things. Forced eye contact is still forced. A rehearsed conversation is still rehearsed. Standard screeners record the outcome, which looks ordinary. MASC asks what the outcome cost you.

It fits people who function at work and then cannot speak for two hours afterwards. People who prepare for social occasions in advance and review them for days afterwards. People who learned their social behaviour by studying characters in films and series, and copied it deliberately. People who have masked so long that who they are underneath is an open question rather than a rhetorical one.

It also fits people who were assessed and told they did not meet the criteria. Masking is a learned skill that works, and a short assessment appointment is exactly the kind of setting it works best in. Being missed once is not evidence that there was nothing to find.

One limit, stated plainly. The validation sample was women and non-binary adults, so the threshold comes from that group. Men can complete MASC and the questions still describe real experience, and the threshold has not been tested for men. This screener is anonymous and collects nothing about you, so it cannot check who is answering. That is why the limit is stated here and in your result rather than enforced.

MASC does not measure how autistic or how ADHD someone is. It measures the camouflage and what the camouflage costs. Those are different things, and keeping them separate is the point of having a masking instrument at all.

Why masking hides neurodivergence from standard tools

Most screening instruments ask about observable traits. Do you find social situations difficult. Do you struggle in conversation. Do you avoid eye contact. Someone who has spent thirty years learning to manage all three answers no honestly, because the behaviour is managed. The instrument records an absence.

What it cannot record is the method. Rehearsing sentences before a phone call. Monitoring your posture and your facial expression while you listen. Copying a colleague's turn of phrase. Suppressing the movements that would actually help you settle. All of that is invisible from outside and none of it appears in the answer.

Masking is learned early and it is reinforced, which is why it is so durable. Being agreeable and prepared attracted less trouble than being visibly different, so it was practised. After enough repetition it stops feeling like a choice. People often cannot report it as effort because they have no ungated version of themselves to compare it with.

This matters most for the groups whose neurodivergence was described last. The diagnostic descriptions of ADHD and autism were built largely around male, externalised presentation, so the traits they name are the traits that are hardest to hide. If your presentation is the one that camouflages well, the standard item sets are pointing at the wrong evidence. Being invisible to a screening tool is not the same as being fine.

MASC is designed for that gap. It asks about the camouflaging directly, and it asks about the cost separately, because the cost is what people usually arrive with. We are not claiming it is more accurate than an established masking questionnaire. It is validated on an initial cohort of 115 women and non-binary adults. Its supplemental modules are still being validated. That is the whole of the evidence at this point.

The five core areas, and the two newer ones

Masking strategies is the largest area at fifteen questions. It covers the mechanics: rehearsing what you will say, monitoring your movements and expressions, forcing eye contact, copying other people, learning social behaviour from films and books, suppressing self-regulatory movement and using punctuation and emojis strategically to make up for what tone of voice would have carried.

Social anxiety is nine questions about fear of being observed or evaluated, difficulty disagreeing, physical anxiety symptoms and the days or weeks of worry that can arrive before a social event.

Exhaustion and burnout is seven questions about what comes afterwards. Needing isolation to recover, being drained for days by something other people found ordinary, signs of burnout tied to the effort of camouflaging and temporarily losing access to tasks you normally do easily.

The effect on your sense of self is nine questions about identity. Pressure to hide your characteristics at work and with family, the difficulty of being authentic, playing a role that does not reflect you and having masked long enough that knowing who you really are has become hard.

Avoiding and concealing is eight questions about the things you no longer do. Not opening messages because a reply would need composing. Re-reading a message many times before sending. Hiding genuine interests to avoid being judged. Avoiding situations where the mask could not be held.

The two newer modules ask about executive masking and executive burnout. Executive masking is four questions about pretending to have understood instructions, presenting work as more organised than the process behind it was and building elaborate systems to cover internal disorganisation without letting anyone see how much they depend on them. Executive burnout is two questions about collapse after days of forced focus, whether or not any social interaction was involved. Both modules are pending separate validation, so they are reported on their own and never folded into your core average.

How to read your result

You get an average out of 4 for each of the five core areas, an average across all forty-eight core questions and a verdict on whether that core average sits above or below the threshold from our validation study. Your highest core area is named for you.

Above the threshold means camouflaging is likely to be costing you real effort and real recovery time. It does not mean you are autistic, it does not mean you have ADHD and it is not a diagnosis of anything. It is a statement about masking.

Below the threshold does not mean nothing is happening. Camouflaging is situational. Someone who masks heavily at work and not at home can average out low while the work situation can still be the thing costing them most. Read your five area averages, and take the highest one seriously even when the average across all forty-eight is modest.

The two newer modules are shown separately with their own averages. They are not validated yet, so treat them as a description of your answers rather than as a measurement.

If you are a man, remember that the threshold comes from a sample of women and non-binary adults. Your area averages still describe your answers accurately. The above or below verdict has not been tested for you, so weigh the areas rather than the verdict.

What to do next

A high masking result is worth acting on, because masking is the main reason people who need an assessment do not get one. The behaviour that hides your traits from a screening tool hides them from a short clinical appointment too, unless the clinician is expecting it.

That is the practical value of bringing a MASC result to an assessment. It gives you language for the effort rather than the outcome, and something concrete to point at when you are asked whether you find social situations difficult and your honest answer is that you have learned to make it look easy.

Our assessments are private and online. A specialist team of two to three practitioners works on your case together, which can include an ADHD clinician, a clinical psychologist and a consultant psychiatrist. You do not need a GP referral, appointments are available immediately and your written report follows within 6 weeks of that first appointment. It is a NICE-compliant report, accepted by the HSE and the NHS. Medication is a separate decision, and our psychiatrist approves that route if you want to look at it. The booking also includes your EchoMind AI profile free of charge, worth €97 or £97 depending on your region.

If masking is one part of a wider question, the other screeners cover different ground. The female-presentation ADHD screener covers internalised ADHD. The AuDHD screener covers both ADHD and autistic traits together. NEXA describes eleven areas of how your neurodivergence expresses itself. All free, and none of them a diagnosis.

Common questions

What is masking?

Masking, also called camouflaging, is the work of adjusting how you present so you come across the way other people expect. Rehearsing conversations in advance, forcing eye contact, monitoring your own facial expressions, copying other people's behaviour and suppressing the movements that would help you settle. It is usually learned young and it usually works, which is why other people rarely see it and why it is tiring to keep doing.

Is MASC validated?

The forty-eight-question core scale is validated on an initial cohort of 115 women and non-binary adults, and it has one threshold from that study. The six supplemental questions about attention, memory and recovery after forced focus are pending separate validation, so they are reported apart from the core average and do not count towards it. There are no percentiles and no severity bands, because the study does not support them.

Can men take MASC?

Yes, and the questions describe real experience for men. The threshold comes from a sample of women and non-binary adults, so it has not been tested for men. Your area averages still describe your answers accurately. Read those rather than the above or below verdict.

Does a high masking score mean I am autistic?

No. MASC measures camouflaging and what it costs you, not autism or ADHD. Camouflaging is common among autistic and ADHD people, and it also occurs for other reasons. A high result is a reason to get assessed properly, not an answer in itself.

How is MASC different from the CAT-Q?

The CAT-Q is an established camouflaging questionnaire and it is well known. MASC is our own instrument, designed for female, non-binary and trans presentation. It goes wider than social camouflage alone. It asks about social anxiety, exhaustion and burnout, the effect on your sense of self and avoidance. The newer modules add hiding attention and memory difficulty. MASC carries much less published evidence than the CAT-Q, which is why the validation status is stated on this page.

What happens to my answers?

The screener is anonymous and needs no account. Your result is saved against a private link, so you can print it or save it as a PDF to bring to an appointment. It is deleted after twelve months.